Changes in liver stiffness during the course of acute hepatitis A

doi:2008.14.4.465

Korean J Hepatol > Volume 14(4); 2008 > Article

The Korean Journal of Hepatology 2008;14(4): 465-473.
doi: https://doi.org/10.3350/kjhep.2008.14.4.465

Changes in liver stiffness during the course of acute hepatitis A

Yeon Seok Seo, M.D., Soon Ho Um, M.D., Sang-jun Suh, M.D., Eun Suk Jung, M.D., Jin Su Jang, M.D., Yong Dae Kwon, M.D., Sang Hoon Park, M.D., Bora Keum, M.D., Yong Sik Kim, M.D., Yoon Tae Jeen, M.D., Hoon Jai Chun, M.D., Chang Duck Kim, M.D., Ho Sang Ryu, M.D.

Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea

ABSTRACT

Backgrounds
/Aims: In some patients with chronic hepatitis, liver stiffness (LS) findings do not reflect fibrosis stage. This study was performed to evaluate whether acute liver inflammation could influence LS findings. Methods: Patients with acute hepatitis A admitted to our hospital were included. Hepatitis was classified on admission using serum ALT and bilirubin levels as inflammation phase, jaundice phase, or recovery phase. Patients who admitted during the recovery phase (whose ALT and bilirubin levels fell continuously during hospitalization) and therefore, their peak-ALT and peak bilirubin levels could not be determined were exduded. Enrolled patients underwent FibroScan during hospitalization and after discharge. Results: Seventy-six patients with acute hepatitis A were enrolled (median age, 29 years; 46 men and 30 women). Among them, 33 (43.4%) and 43 (56.6%) patients were admitted during the inflammation phase and jaundice phase, respectively. For patients admitted during the inflammation phase, mean (±SD) time from symptom-onset day to maximum ALT level was 7 (±3) days. For all patients, mean time from symptom-onset to maximum bilirubin level was 11 (±4) days. Mean LS during admission was 8.9 (±3.3) kPa (median, 8.4 kPa). LS was significantly correlated with serum bilirubin level, which was the only factor found to be significantly associated with the increased LS (>7.08 kPa). In all patients, LS increased gradually from the symptom-onset and peaked at 8-9 days later. Conclusions: Severe hepatic inflammation can affect the LS findings and thus, care is required when assessing fibrosis stage using LS measurement in patients with severe inflammation. (Korean J Hepatol 2008;14:465-473)

KeyWords: Liver stiffness; Fibrosis; Inflammation; Acute hepatitis